Normohormonal primary hyperparathyroidism is a distinct form of primary hyperparathyroidism

Background Normohormonal primary hyperparathyroidism presents diagnostic and intraoperative challenges, and current literature is conflicting about management. We aim to better define normohormonal primary hyperparathyroidism in order to improve the care for these patients. Methods In the study, 516...

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Bibliographic Details
Published in:Surgery 2017-01, Vol.161 (1), p.62-69
Main Authors: Applewhite, Megan K., MD, White, Michael G., MD, Tseng, Jennifer, MD, Mohammed, Maryam K., BA, Mercier, Frederic, MD, Kaplan, Edwin L., MD, Angelos, Peter, MD, PhD, Vokes, Tamara, MD, Grogan, Raymon H., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Calcium - blood
Cohort Studies
Female
Follow-Up Studies
Humans
Hyperparathyroidism, Primary - blood
Hyperparathyroidism, Primary - diagnostic imaging
Hyperparathyroidism, Primary - surgery
Male
Middle Aged
Parathyroid Hormone - blood
Parathyroidectomy - adverse effects
Parathyroidectomy - methods
Postoperative Complications - epidemiology
Postoperative Complications - physiopathology
Reference Values
Retrospective Studies
Risk Assessment
Severity of Illness Index
Surgery
Time Factors
Treatment Outcome
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Summary:Background Normohormonal primary hyperparathyroidism presents diagnostic and intraoperative challenges, and current literature is conflicting about management. We aim to better define normohormonal primary hyperparathyroidism in order to improve the care for these patients. Methods In the study, 516 consecutive patients undergoing parathyroidectomy for primary hyperparathyroidism were divided into 2 groups: classic primary hyperparathyroidism (classic primary hyperparathyroidism, increased serum levels of calcium, and parathyroid hormone) and normohormonal primary hyperparathyroidism (hypercalcemia, normal serum levels of parathyroid hormone). We evaluated inter-group differences in presentation, gland weight, pathology, and complications. Results The normohormonal primary hyperparathyroidism group was comprised of 116 (22.5%) patients. Mean serum levels of parathyroid hormone and calcium were 62.1 pg/mL ± 10.1 and 10.6 mg/dL ± 0.63 in normohormonal primary hyperparathyroidism, and 142 ± 89.0pg/mL and 11.0 ± 0.88 (both P  
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2016.03.038